[Perinatal asphyxia and cerebral palsy: medicolegal implications]

Over the last 30 years, improvements in obstetric practice (systematic fetal perpartum monitoring, Caesarean section, etc.) have markedly reduced the incidence of perinatal asphyxia, especially in the perpartum period. Yet the incidence of cerebral palsy has remained stable, at around 2 per 1000 live births, owing to the fact that this disorder is generally due to antenatal factors. Population-based studies have further demonstrated that acute perpartum asphyxia is a rare cause of cerebral palsy. Obstetrics is a discipline particularly subject to insurance claims, often because of late use or non use of Cesarean section. Perinatal judicial expertise is too often based on obsolete notions. Reform is necessary, focusing on upstream structural problems. The American model initiated by neurologists and adopted by many other disciplines should be widely adopted, including by lawyers and magistrates. It involves verifying the ethical character of the expertise challenged by the injured party, and drawing conclusions for professional practice?